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High-risk chest radiographic features associated with COVID-19 disease severity.
Ong, Sean Wei Xiang; Hui, Terrence Chi Hong; Lee, Yeong Shyan; Haja Mohideen, Salahudeen Mohamed; Young, Barnaby Edward; Tan, Cher Heng; Lye, David Chien.
  • Ong SWX; National Centre for Infectious Diseases, Singapore, Singapore.
  • Hui TCH; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
  • Lee YS; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Haja Mohideen SM; Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore.
  • Young BE; Department of Diagnostic Radiology, Singapore General Hospital, Singapore, Singapore.
  • Tan CH; National Centre for Infectious Diseases, Singapore, Singapore.
  • Lye DC; Department of Infectious Diseases, Tan Tock Seng Hospital, Singapore, Singapore.
PLoS One ; 16(1): e0245518, 2021.
Artículo en Inglés | MEDLINE | ID: covidwho-1067418
ABSTRACT

OBJECTIVES:

High-risk CXR features in COVID-19 are not clearly defined. We aimed to identify CXR features that correlate with severe COVID-19.

METHODS:

All confirmed COVID-19 patients admitted within the study period were screened. Those with suboptimal baseline CXR were excluded. CXRs were reviewed by three independent radiologists and opacities recorded according to zones and laterality. The primary endpoint was defined as hypoxia requiring supplemental oxygen, and CXR features were assessed for association with this endpoint to identify high-risk features. These features were then used to define criteria for a high-risk CXR, and clinical features and outcomes of patients with and without baseline high-risk CXR were compared using logistic regression analysis.

RESULTS:

109 patients were included. In the initial analysis of 40 patients (36.7%) with abnormal baseline CXR, presence of bilateral opacities, multifocal opacities, or any upper or middle zone opacity were associated with supplemental oxygen requirement. Of the entire cohort, 29 patients (26.6%) had a baseline CXR with at least one of these features. Having a high-risk baseline CXR was significantly associated with requiring supplemental oxygen in univariate (odds ratio 14.0, 95% confidence interval 3.90-55.60) and multivariate (adjusted odds ratio 8.38, 95% CI 2.43-28.97, P = 0.001) analyses.

CONCLUSION:

We identified several high-risk CXR features that are significantly associated with severe illness. The association of upper or middle zone opacities with severe illness has not been previously emphasized. Recognition of these specific high-risk CXR features is important to prioritize limited healthcare resources for sicker patients.
Asunto(s)

Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Estudio de cohorte / Estudio observacional / Estudio pronóstico Límite: Adulto / Femenino / Humanos / Masculino / Middle aged Idioma: Inglés Revista: PLoS One Asunto de la revista: Ciencia / Medicina Año: 2021 Tipo del documento: Artículo País de afiliación: Journal.pone.0245518

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Texto completo: Disponible Colección: Bases de datos internacionales Base de datos: MEDLINE Asunto principal: COVID-19 Tipo de estudio: Estudio de cohorte / Estudio observacional / Estudio pronóstico Límite: Adulto / Femenino / Humanos / Masculino / Middle aged Idioma: Inglés Revista: PLoS One Asunto de la revista: Ciencia / Medicina Año: 2021 Tipo del documento: Artículo País de afiliación: Journal.pone.0245518